Showing posts with label CERVICAL CANCER. Show all posts
Showing posts with label CERVICAL CANCER. Show all posts

Saturday, June 22, 2013

What is cervix cancer?






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What is cervix cancer?
What is cervix cancer? (Thinkstock photos/Getty Images)
Cancer of the uterine cervix (the lower part of the uterus womb) which extends slightly into the top of the vagina, is one of the most common cancers in women.

The oncologist specialist team at BNH HCG Cancer Center, a unit of HCG - Dr. Bhavana Parikh, Consultant, Medical Oncologist, Dr. Deepak Patkar, Consultant, Radiologist and Dr. Sanjay Dudhat, Consultant, Surgical Oncologist, helps us to understand cervix cancer in detail and help prevent it.

What is cervix cancer?

A very common early symptom is abnormal vaginal bleeding. This cancer is mostly reported in women who are in their 30s or 40s. Ifcervical cancer is diagnosed at an early stage, there is a good chance of a cure. Regular cervical screening tests can select 'pre-cancer', which can be treated before cancer develops.

What is important is that you promptly report any abnormal vaginal bleeding (bleeding in between periods, heavy periods, bleeding after intercourse) or vaginal discharge to a doctor.

Types of cervical cancer

There are two main types of cervical cancer

Squamous cell cervical cancer is the most common. This develops when a skin-like cell (a squamous cell) that covers the cervix, becomes cancerous.

Adenocarcinoma cervical cancer is less common. This develops when a glandular cell (a cell that makes mucus) within the cervical canal, becomes cancerous.

Both types are diagnosed and treated in a similar way. Most cases develop in women in their 30s or 40s. While some cases develop in older women, it is rare in women under 25 years.

Screening for cervical cancer

Women should know about and be offered regular cervical screening tests. The test involves scraping cells from the surface of the cervix, for laboratory examination. Dyskaryotic cells are seen in some cases, which means that some cells of the cervix are abnormal, but are not cancerous. Depending on the degree of the abnormality of the cells, cervical dysplasia are classified as:

Mild - this is when there are only slight cell changes. This is sometimes called CIN 1 (cervical Intra-epithelial Neoplasia)

Moderate (or CIN 2)

Severe (or CIN 3). This is when teh cells are very abnormal, but are still not cancerous.

In many cases, the abnormal cells do not become cancerous, and can revert back to normal within a few months. However, in some cases, often years later, the abnormal cells turn cancerous. If a woman has just slight abnormal changes (CIN 1), she may simply be offered another test sooner than normal. Treatment may be offered if the abnormality persists. For women with moderate or severe abnormal changes, treatment can clear the cervix of abnormal cells before they develop into cancer.

Causes of cervical cancer

A cervical tumour starts from one abnormal cell. The exact reason why a cell becomes cancerous and multiplies 'out of control' is still unclear. The initial 'pre-cancerous' abnormality of cervical cells is usually caused by a prior infection with Human Papilloma Virus (HPV)

Other factors:

Other factors that increase the risk of developing cervical cancer:

Smoking: Smokers are more likely than non-smokers to develop certain cancers, including cervical cancer. If you smoke and have HPV infection, the risk is compounded.

A poor immune system: People with AIDS or people taking immunosuppressant medication have an increased risk.

Oral contraception pill: A possible link between the oral contraceptive pill and an increased risk of cervical cancer (if the pill is taken for more than eight years) has been mooted. 

Symptoms of cervical cancer

Women may have no symptoms when the tumour is small. As the tumour becomes larger, in most cases the first symptom to develop is abnormal vaginal bleeding such as:

Bleeding between normal periods (intermenstrual bleeding)

Bleeding after having sex (post-coital bleeding)

Any vaginal bleeding in women post menopause

An early symptom in some cases is a vaginal discharge that smells unpleasant, or discomfort or pain during sex. In time, if the cancer spreads to other parts of the body, various other symptoms can develop.

All of the above symptoms can be caused by various other common conditions. If a woman develops any of these symptoms, she should have it checked by a doctor.

Diagnosis and assessment of cervical cancer

To confirm the diagnosis

A doctor will usually do a vaginal examination if a woman has symptoms which may indicate cervical cancer.

The doctor may feel an abnormal cervix.

If cervical cancer is suspected, a colposcopy (a more detailed examination of the cervix) is advised.

For this test a speculum is gently put into the vagina so the cervix can be seen in detail using a magnifier (colposcope)

The test takes about 15 minutes.

During a colposcopy it is usual to take a small piece of tissue from the cervix. The biopsy sample is then examined under a microscope to look for cancer cells.

Assessing the extend and spread

CT scan

An MRI scan

A chest X-ray

An ultrasound scan

Blood test or other tests

This assessment is called 'staging' of the cancer. The aim of staging id to find out:

How much the tumour has grown, and whether it has grown to other nearby structures such as the bladder or rectum.

Whether the cancer has spread to local lymph glands (nodes).

Whether the cancer has spread to other areas of the body.

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Saturday, May 11, 2013

CERVICAL CANCER WORKSHOP SUMMARY

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In collaboration with:
senologylogo      CancerQuest

http://link.talkabouthealth.com/view/4c617cd4b61807701edfefceztpp.1/492f2591

Cervical Cancer Workshop Summary

Stewart Massad, MD
Today’s Q&A workshop summary is with Stewart Massad, MD, Professor of Obstetrics and Gynecology, Division of Gynecologic Oncology, Washington University School of Medicine.




Q: At what point in the process does a cervical cancer patient see the gynecologic oncologist? 
A: This depends on the training and comfort level of the clinician. All women requiring radical therapy (generally, stage IA2 and above) should be seen by someone with special expertise in cervical cancer management, usually a gynecologic oncologist. Stage IA1 cervical cancers without lymphovascular space invasion can be managed with conization using scalpel or loop or with simple hysterectomy. Ablational treatments are contraindicated. However...
(read more)
Q: Should I be worried if my pap smear comes back abnormal? Does this mean I have cervical cancer?
A: A Pap test is a screening test for cervical cancer. For the most common abnormalities (ASC-US and LSIL), the risk of cervical cancer is about 1/1000, rising with age and smoking. You should be worried enough to get prompt assessment (generally within 6-8 weeks), but you are unlikely to have cervical cancer... 
(read more)
Q: If atypical squamous cells (ASC) are found in my pap smear, how is the risk level of cervical cancer determined?
A: There are two types of ASC, and management differs.For women with ASC of undetermined significance (ASC-US), most centers in the US determine risk for cervical cancer using a test for oncogenic/high risk human papillomavirus (HPV). HPVs are the viruses that cause cervical cancer. However, more than 80% of sexually active women will have an HPV infection at some point, and 90% will clear spontaneously on immune recognition of the virus, so having HPV does not prompt treatment. Low risk HPV types are not associated with cervical cancer, and there’s no role for testing for these types. Women with ASC-US and high-risk HPV are at increased risk for cervical precancer, and are at long-term risk for cervical cancer, though few have cancer at the time of their abnormal Pap. Women with ASC-US who are HPV+ need colposcopy to inspect the cervix, with biopsy of any abnormality. The biopsy then.. 
(read more)
Q: What does it mean if I have a normal Pap test, but a positive HPV test? 
A: This means that you are infected with HPV. Only high-risk types of HPV should be tested for. A positive test for high-risk HPV means that risk for developing cancer over one’s lifetime is elevated, though immediate risk is low. Women who are Pap- but HPV+ should have both tests repeated in a year. Two types of HPV (types 16 and 18) carry highest cancer risk, and an alternative is to test for these types. If either is present, colposcopy is indicated to assess for precancer or even rare cancers. Women who... 
(read more)
Q: What are the treatment options if high-grade squamous intraepithelial lesions (HSILs) are found during cervical cancer screening? 
A: reatment with a loop electrosurgical excision procedure (LEEP) can be done for all women with HSIL. This involves removing the surface of the cervix with an electrified wire, usually as an office procedure with intracervical anesthetic. Risks of LEEP include bleeding (sometimes delayed 5-10 days), injury to surrounding organs, and infection. One concerning complication is an increased risk for preterm delivery in subsequent pregnancies, especially after deep or repeated LEEPs, though this risk has not been found in all studies; most women with LEEP who conceive deliver at term, and most preterm deliveries are at 34-36 weeks gestation and do well, though extreme prematurity also appears to be increased... 
(read more)
Q: What are the options for doing a biopsy for cervical cancer? How do you decide which type of biopsy to perform? 
A: When a clinician sees a cervical mass, biopsy can be done immediately using forceps designed for that purpose. When cervical cancer is suspected on the basis of colposcopy or Pap, biopsy is directed to the most abnormal areas of the cervix using colposcopic biopsy forceps. If biopsy is negative or shows only microinvasive cancer, then conization using scalpel or wire is indicated to fully assess the cervix. LEEP conization can be done as an office procedure, while scalpel conization is usually done under general anesthesia in an operating room... 
(read more)
Q: If metastatic cervical cancer is diagnosed, what are the next steps? 
A: In the US, previously untreated metastatic cervical cancer is assessed using pelvic exam and imaging. CT scan, usually supplemented by PET scanning, is the most common imaging test. These scans assess for sites of metastasis other than those initially suspected. Staging in this manner determines therapy. When metastases are only regional (restricted to the pelvis and occasionally to the pelvis and groin or para-aortic lymph nodes), radiotherapy is standard, supplemented with cisplatin chemotherapy as a radiation booster. Radiation must include both external and internal sources. For the latter, radiation instruments are inserted temporarily into the uterus, cervix, and vagina, then loaded with radio-isotopes to provide intense dosing directly into the cancer. Surgery is... 
(read more)
Q: For metastatic cervical cancer, what factors determine if surgery is a recommended treatment? 
A: This is addressed here... 
(read more)
http://link.talkabouthealth.com/view/4c617cd4b61807701edfefceztpp.1/492f2591

Wednesday, March 13, 2013


Being frank about sex: How I reclaimed my lady parts after cervical cancer

BY GUEST BLOGGER | JANUARY 18, 2013
I love Mark, my husband of nearly four months, and yet I couldn't bear the thought of him touching me. Our newly wed life was not going as we had imagined. In fact, I avoided undressing in front of him and hugged the edge of our bed at night. He took his cues from me and never attempted to cross the invisible barrier in the center of our bed. I knew I wasn't being fair to him. I wanted to invite him in. I longed to be the way we were before, but I just couldn't do it.
At the time, I couldn't see it yet, but today I know am a survivor; a survivor of gynecological cancer. Not once, but twice. My body had been ravaged by two surgeries: one vaginal and the other abdominal followed by chemo and radiation all before the age of 30. When it was all said and done, I had 2 inches of vaginal canal left and it had atrophied from the radiation treatment. I consider myself a bright girl and knew the old saying it's not about size but technique; but let's be real: with what I had left of my lady parts, every tool in the shed was going to be large and not in a good way. I was terrified. I had already suffered such severe pain during my battle I just could not wrap my brain around willingly subjecting myself to more. Sex was going to be painful and I did not want any part of that physical pain. I hadn't yet realized the emotional pain it was causing both my husband and me.
Remember the fear and anticipation you had the first time you had sex? Now imagine doing it with "damaged goods." At least the first time around I didn't know what sex was supposed to feel like. Therefore, that first guy didn't have much to live up to. Today, the stakes were higher. I desperately wanted to feel normal. I wanted my new husband to still find me sexy and desire me. I wanted an orgasm and for him to enjoy being inside me, but the fear of pain paralyzed me.
The pressure was intense. Neither of us wanted to hurt the other or be disappointed ourselves. So we did nothing. We didn't talk about it. We acted like it wasn't there. Suddenly, I found myself insecure for the first time ever. When he'd go out for a drink with his brother to unwind, I couldn't resist imagining some hot, sexy girl making a move on him. Hell, he was hot, young, and still had a fully active sex drive with no outlet at home. I realized it was crazy thinking. He loved me. He had willingly married me even knowing I had cancer. He would never stray; I knew it logically, but emotionally it was taking a toll on us.
It was then that I knew I had to act. I was ready to take my life and my sex life back. I met with my medical team and explained the situation. I could sense the tension in the room; even the doctors were uncomfortable with the sex topic. Immediately, I was handed a set of dilators without much explanation.
At home, I opened the box to find what looked like candle sticks with a rounded top. Was this a bad joke, I wondered. The length of each dilator was the same but the diameters were not; I had small, medium and large. I decided to share my new tools with Mark. I could see the curiosity on his face. I explained their purpose was to help stretch my vaginal walls in hope of someday enjoying sex again. Even as I explained what they were, I secretly wondered why they were so sterile and boring looking. I imagined them being replicas of an 1800's dildo.
We decided to do the dilation together. Some couples eat popcorn while watching TV; we dilated.
We agreed to take the process of rediscovery slowly. We drank wine and played music. Naked cuddle time became our favorite pastime along with hot baths. It was so nice to be close and feel physically connected again. Slowly, I became more comfortable in my new normal.
Then one night I sat on the bed and said, "Do you want to f*#k?" I think Mark almost fell over. He jumped at the opportunity but made sure I knew we didn't have to. But we did. We had to try sometime, and my doctors kept saying, "use it or lose it." The vagina is a muscle and stretches for childbirth, so surely it would stretch for sex. At least that's what I told myself while searching for the courage to try. That first night, I held a pillow over my head and cried. I only allowed him a few minutes of penetration and it felt like a knife slicing into me. I hurt and, at the same time, felt relieved that we had had sex. Sex was a job at that point; tough, painful and draining. We were determined to keep trying.
Eventually, we upgraded those medical dilators for something more fun. I strongly advise visiting your local pleasure store--there are all sorts of things to try and explore. The more we explored each other, the more I realized I was a big part of my own problem. My body had been through hell and back. It was just as painful as I feared. However, I was still giving into the fear. I was mentally bracing myself for the pain and tensing up when Mark touched me. My actions were actually adding to my pain and preventing me from finding any enjoyment. I had to get outside my own head. So I experimented with relaxation techniques. I found a little liquid courage helpful, along with a hot bath before the act. We indulged in more foreplay. Then it happened. I actually had an orgasm. I was back!
Achieving an orgasm after all I had experienced gave me hope. Hope that my love life could be good again, and in time, maybe even great. Repeating, that act took time. It was like finding a needle in a haystack. I wanted that needle and was determined to get it. Check out my tips for reclaiming your sex life and share my tips from my husband with your partner.
Check out my tips for reclaiming your sex life and share my tips from my husband with your partner.
Michelle Whitlock
Michelle Whitlock is the award-winning author of the memoir, How I Lost My Uterus and Found My Voice. Michelle's story shares her falling in love, battling HPV and cervical cancer, facing sexual dysfunction, confronting her conflicting feelings about motherhood and becoming her own best advocate. Michelle lives in Cordova, Tenn., with her husband, Mark; their daughters, Riley Grier and Shelby-Kay; and their four-legged children, George and Charlee.